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Review Article
Cellular and Molecular Aspect of Bladder Pain Syndrome: An Entry Point to Exploration of Its Pathogenesis
Kuni Zakiyyah Sumargo
,
Abdi Dzul Ikram Hasanuddin*
Issue:
Volume 8, Issue 2, December 2024
Pages:
12-18
Received:
12 June 2024
Accepted:
5 July 2024
Published:
15 July 2024
Abstract: Background: Bladder pain syndrome/interstitial cystitis (BPS/IC) can cause pelvic pain, frequent urination, and a strong urge to urinate. These symptoms can significantly reduce quality of life, causing psychological distress, sexual dysfunction, poor sleep quality, decreased work productivity, and increased morbidity. Despite the prevalence of this condition, determining the most effective treatment guidelines for BPS/IC remains a challenge due to the complexity of its pathogenesis. Objective: Understanding cellular and molecular aspects is essential to explore different cell types in changes in function and sensitivity of the urothelial layer and chronic inflammation. Main Ideas: Cellular aspects in the pathogenesis of BPS/IC include Umbrella Cells, Basal and Intermediate Cells, Paraneuron Cells, Myofibroblasts and Telocytes, Detrusor Smooth Muscle Cells, Nerve Cells, Astrocytes, Microglia, CD68+ Macrophages, CD74+ Lymphocytes, Eosinophils, and Mast Cells. Disruption of these cells leads to altered urothelial barrier function, sensitivity, and chronic inflammation. Molecular aspects include chronic inflammation with increases in p38-mitogen activated protein kinase (p38 MAPK), Interleukin-1β (IL-1β), Interleukin-6 (IL-6), Tumor Necrosis Factor-α (TNF-α), Nerve Growth Factor (NGF), Brain-Derived Neurothropic Peptide (BDNF), and other molecules. Conclusion: Changes in the urothelial barrier and bladder wall sensitivity are also significant. Complex interactions between the immune and nervous systems contribute to chronic inflammation through positive feedback. Therefore, this article aims to understand the cellular and molecular aspects that play a role in the pathogenesis of BPS/IC and help provide appropriate treatment.
Abstract: Background: Bladder pain syndrome/interstitial cystitis (BPS/IC) can cause pelvic pain, frequent urination, and a strong urge to urinate. These symptoms can significantly reduce quality of life, causing psychological distress, sexual dysfunction, poor sleep quality, decreased work productivity, and increased morbidity. Despite the prevalence of thi...
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Case Report
Rare Case of Testicular Metastasis of Prostate Carcinoma after 13 Years of Prostatectomy: A Case Report and Review of the Literature
Issue:
Volume 8, Issue 2, December 2024
Pages:
19-22
Received:
7 May 2024
Accepted:
21 May 2024
Published:
23 July 2024
Abstract: Metastasis of prostate cancer to the testes is a rare phenomenon, often indicating advanced-stage disease. This case report details a 79-year-old man with a history of prostate cancer, who underwent endoscopic-extraperitoneal radical prostatectomy and bilateral pelvic lymph node dissection. The patient subsequently received radiation therapy for local recurrences. Thirteen years post-surgery, a testicular ultrasound revealed a cystic mass in the left testis, initially suspected to be a primary neoplasm. However, pathology with immunohistochemical analyses confirmed metastasis from prostate adenocarcinoma. Testicular metastasis of prostate cancer is uncommon, underscoring the aggressiveness and potential spread of the tumor. Clinically evident testicular metastases develop in only a small percentage of prostate cancer patients. This case report highlights the importance of considering metastatic disease in the differential diagnosis of testicular masses and the necessity of clinicopathologic correlation in such evaluations. Early detection and accurate diagnosis are crucial for managing testicular metastasis and improving patient outcomes. The case also emphasizes the significance of long-term follow-up in prostate cancer patients, as metastasis can occur many years post-initial treatment. Furthermore, it illustrates the critical role of advanced imaging techniques and thorough pathological assessments in identifying and managing metastatic spread. This report contributes to the limited but growing body of literature on testicular metastasis from prostate cancer, providing insights for clinicians in recognizing and managing this rare but serious complication. It underscores the need for ongoing research to better understand the mechanisms of metastatic spread and develop targeted therapeutic strategies.
Abstract: Metastasis of prostate cancer to the testes is a rare phenomenon, often indicating advanced-stage disease. This case report details a 79-year-old man with a history of prostate cancer, who underwent endoscopic-extraperitoneal radical prostatectomy and bilateral pelvic lymph node dissection. The patient subsequently received radiation therapy for lo...
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Research Article
Histopathologic Patterns of Urinary Bladder Lesions and Associated Factors in Hawassa University Comprehensive Specialized Hospital, Sidama Region, Ethiopia
Issue:
Volume 8, Issue 2, December 2024
Pages:
23-34
Received:
2 September 2024
Accepted:
20 September 2024
Published:
18 October 2024
Abstract: Background: Urinary bladder lesions, non-neoplastic and neoplastic, are collectively responsible for significant morbidity and mortality throughout the world. Bladder cancer is a prevalent disease affects a significant number of individuals each year worldwide. The most common non-neoplastic and neoplastic lesion of the urinary bladder is non-specific cystitis and urothelial carcinoma respectively. Objectives: The aim of this study is to describe histopathologic patterns of urinary bladder lesions and associated risk factors in Hawassa University Comprehensive Specialized Hospital from January 2017 to December 2023. Methods: A 7-year cross sectional study was conducted to describe histologically diagnosed bladder lesions and associated factors at Hawassa University Comprehensive Specialized Hospital from January 2017 to December 2023. Results: This study comprised a total of 182 patients who have bladder biopsies at Hawassa University Comprehensive Specialized Hospital, Pathology department from January 2017 to December 2023. Out of which 21 cases (12.1%) are non-neoplastic, while 152 cases (83%) are neoplastic. Nine cases (4.9%) have a descriptive diagnosis. With 139 (90.44%) cases, urothelial neoplasms have the highest frequency form all neoplastic lesions. Ninety-seven cases, or 69.8%, of urothelial neoplasms were invasive; of them, 78 (80.4%) were high grade cases. Low-grade noninvasive papillary carcinomas, which accounted for 24 instances. One case is a cystectomy specimen, and the remaining 181 cases are TURBT. The age range of 50-59 years was the most frequent accounting for 39 (21.4%) of all cases, with a male to female (M: F) ratio of 2.9:1. The most frequent presenting symptom in 146 (85.7%) of patients was hematuria. Conclusions: This study demonstrates that 139 (90.44%) of the neoplastic bladder lesions were bladder neoplasms of urothelial origin, 97 (69.8%) of which are invasive urothelial carcinoma with rising numbers each year and implying the burden in the region.
Abstract: Background: Urinary bladder lesions, non-neoplastic and neoplastic, are collectively responsible for significant morbidity and mortality throughout the world. Bladder cancer is a prevalent disease affects a significant number of individuals each year worldwide. The most common non-neoplastic and neoplastic lesion of the urinary bladder is non-speci...
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Case Report
Late Local Recurrence of Carcinoma in situ - Only Bladder Cancer
Masanori Nishimura*,
Syun Ueno,
Takeshi Nomura
Issue:
Volume 8, Issue 2, December 2024
Pages:
35-38
Received:
13 September 2024
Accepted:
14 October 2024
Published:
12 November 2024
DOI:
10.11648/j.ijcu.20240802.14
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Abstract: Late recurrence (LR) of bladder cancer after radical cystectomy (RC) is rare, and few studies have been conducted. We report a case of local LR of bladder cancer 10.3 years after RC. The pathology at RC was almost carcinoma in situ (CIS) only. The patient underwent metastasectomy, and treatment with an immune checkpoint inhibitor (ICI) achieved a complete response (CR). A 61-year-old woman was referred to our hospital for macrohematuria and bladder irritability in June 2012. She underwent RC along with pelvic lymph node dissection and ileal conduit creation. The pathologic findings were CIS, G2>G3, pT1, pN0. She visited our hospital with complaints of lower abdominal discomfort in November 2022, and recurrence was found on the pelvic floor by abdominal computed tomography. Metastasectomy confirmed metastasis of urothelial carcinoma. As salvage therapy, systemic chemotherapy with a platinum agent and an ICI were administered, leading to CR. Long-term follow-up should be considered for patients with bladder cancer, even for early-stage CIS-only tumors. Metastasectomy could be the primary option for LR of bladder cancer after RC.
Abstract: Late recurrence (LR) of bladder cancer after radical cystectomy (RC) is rare, and few studies have been conducted. We report a case of local LR of bladder cancer 10.3 years after RC. The pathology at RC was almost carcinoma in situ (CIS) only. The patient underwent metastasectomy, and treatment with an immune checkpoint inhibitor (ICI) achieved a c...
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